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Clinical predictors of post-traumatic seizures in children with head trauma.

Publication ,  Journal Article
Lewis, RJ; Yee, L; Inkelis, SH; Gilmore, D
Published in: Ann Emerg Med
July 1993

STUDY OBJECTIVES: To determine the clinical characteristics associated with early post-traumatic seizures in children with head trauma. DESIGN, SETTING, AND TYPE OF PARTICIPANTS: Retrospective chart review; urban trauma center/pediatric emergency department. Trauma patients aged 3 months to 15 years given discharge diagnosis ICD-9-CM codes indicating head trauma and seen from 1988 to 1990 were eligible for the study. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 194 patients, 96% suffered blunt trauma and 53% had a loss of consciousness. Fifty-one percent of 141 computed tomography (CT) scans of the head were abnormal, most frequently demonstrating skull fractures (34%), subdural hematomas (15%), and cerebral contusions (14%). Eighteen patients (9.3%) suffered post-traumatic seizures. A loss of consciousness, a low Glasgow Coma Scale (GCS) score (3 to 8), and an abnormal CT scan were associated with post-traumatic seizures (P < .02, .001, and .02, respectively). However, only a low GCS score was predictive of post-traumatic seizures when these factors were considered simultaneously (P < .001), with 38.7% of patients with low GCS scores suffering post-traumatic seizures and 3.8% of patients with high GCS scores suffering post-traumatic seizures. In children with low GCS scores, treatment with phenytoin was associated with a decrease in post-traumatic seizures. CONCLUSION: In the pediatric head trauma patient, a GCS score of 3 to 8 appears to be predictive of post-traumatic seizures. The data from this retrospective study are consistent with the hypothesis that prophylactic phenytoin reduces post-traumatic seizures in the pediatric head trauma patient with a low GCS score.

Duke Scholars

Published In

Ann Emerg Med

DOI

ISSN

0196-0644

Publication Date

July 1993

Volume

22

Issue

7

Start / End Page

1114 / 1118

Location

United States

Related Subject Headings

  • Unconsciousness
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Seizures
  • Risk Factors
  • Retrospective Studies
  • Phenytoin
  • Male
  • Logistic Models
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
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Lewis, R. J., Yee, L., Inkelis, S. H., & Gilmore, D. (1993). Clinical predictors of post-traumatic seizures in children with head trauma. Ann Emerg Med, 22(7), 1114–1118. https://doi.org/10.1016/s0196-0644(05)80974-6
Lewis, R. J., L. Yee, S. H. Inkelis, and D. Gilmore. “Clinical predictors of post-traumatic seizures in children with head trauma.Ann Emerg Med 22, no. 7 (July 1993): 1114–18. https://doi.org/10.1016/s0196-0644(05)80974-6.
Lewis RJ, Yee L, Inkelis SH, Gilmore D. Clinical predictors of post-traumatic seizures in children with head trauma. Ann Emerg Med. 1993 Jul;22(7):1114–8.
Lewis, R. J., et al. “Clinical predictors of post-traumatic seizures in children with head trauma.Ann Emerg Med, vol. 22, no. 7, July 1993, pp. 1114–18. Pubmed, doi:10.1016/s0196-0644(05)80974-6.
Lewis RJ, Yee L, Inkelis SH, Gilmore D. Clinical predictors of post-traumatic seizures in children with head trauma. Ann Emerg Med. 1993 Jul;22(7):1114–1118.
Journal cover image

Published In

Ann Emerg Med

DOI

ISSN

0196-0644

Publication Date

July 1993

Volume

22

Issue

7

Start / End Page

1114 / 1118

Location

United States

Related Subject Headings

  • Unconsciousness
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Seizures
  • Risk Factors
  • Retrospective Studies
  • Phenytoin
  • Male
  • Logistic Models
  • Infant